When Mammograms Lie

Wednesday, 11 Jun 2014 09:37 AM

By Lynn Allison

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Susan Quinn-Mullins discovered a lump about the size of a marble on her left breast. Could it be cancer? She didn't think so. Just four months earlier she had a mammogram and it was normal.
 
But an ultrasound revealed it was a tumor nestled in dense breast tissue that hadn't been picked up by the mammogram. It turned out to be an aggressive and invasive tumor headed to the surrounding lymph nodes.
 
Quinn-Mullins had a mastectomy, followed by a year of chemotherapy and radiation, along with experimental drugs. After the shock of her diagnosis came the anger. She had been fastidious about having regular mammograms and nothing abnormal had ever been reported.
 
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"I had a very aggressive cancer and most likely it was there when I had my last mammogram," she says. Fortunately, through a support group, she was able to work through the anger and come to peace with her ordeal.
 
For decades women have been urged to have regular mammograms, but recent studies have questioned their effectiveness in preventing cancer deaths or even in detecting cancer.
 
Experts say the screening misses up to 25 percent of breast tumors. On the other side, mammograms can lead to unnecessary treatment for tumors that are unlikely to spread or be a health threat. Women with dense breast tissue, like Quinn-Mullins, have a greater risk of having tumors going unnoticed.
 
In some cases the woman isn't positioned properly, causing a faulty test result, or the radiologist misreads the scan. But the most common reason for a false-negative mammogram is that tumors are hidden by dense tissue in the breast.
 
"The only really conclusive method to detect breast cancer, especially in women who have dense tissue, is with an MRI," says Dr. Erika Schwartz, one of the nation's leading women's health experts.
 
"We have let the fear mongers scare us to thinking that mammograms are the greatest thing since sliced bread. It's not so much that mammograms lie, it is that they don't always get the whole picture."
 
A University of Toronto study that appeared earlier this year found that annual screening of women aged 40 to 59 years did not lower the breast cancer death rate despite federal recommendations that women in this age group get mammograms each year.
 
Dr. Schwartz, who personally eschews mammograms, believes that breast cancer prevention should be a greater priority than getting mammograms.
 
"We didn't have as much cancer when we ate pure, organic foods and not processed food with chemicals that mutate our cells," she says.
 
"We are bombarded with chemicals and stress — factors that cause cancer. Embracing a healthier lifestyle can prevent breast cancer, mammograms cannot."
 
In fact, mammograms themselves may present a danger. Although a woman gets just a small dose of radiation each time she gets a mammogram, the effect of the radiation is cumulative over a patient's life. So if a woman gets many mammograms over the years, the total amount of radiation she gets adds up to the point where it could actually cause breast cancer.
 
This has led more experts to recommend that women wait until mid-life to begin mammograms.
 
"Women should empower themselves instead being scared to death about mammogram results, or depending on mammograms as the sole source of cancer prevention and detection," says Dr. Schwartz, author of Dr. Erika's Healthy Balance newsletter. "We have been so brain-washed and fear-stricken about breast cancer that we can’t hear anything else."
 
Dr. Schwartz says that it is crucial that women should "get to know their breasts" to detect any changes in shape or tissue. They should also have regular doctor checkup, genetic testing, ultrasound and MRI scans while adhering to healthy habits.
 
"At the end of the day it should be an individual decision," she says. "We have been flooded with information about all the so-called benefits of mammograms, but the risks have been downplayed. Now that is changing. It’s a question of balance."
 
With hindsight making her wiser, Susan Quinn-Mullins says had she been alerted to the limitations of mammograms, "I would have definitely pushed for more than just a mammogram."
 
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